Adult Granulosa Cell Tumor in Pregnancy: A New Case and a Review of the Literature.

Sofia Guidi,Stefano Restaino,Annalisa Vidiri,Anna Fagotti,Giovanni Scambia,Frediano Inzani,Giuseppe Vizzielli,Anna Franca Cavaliere,Vincenzo Berghella

doi:10.3390/healthcare9111455

Abstract

Granulosa cell tumors are rare ovarian tumors that can arise during pregnancy. We present a new case of recurrent adult granulosa cell tumor (AGCT) in pregnancy and a systematic review of the literature. The new case described is a 41-year-old woman G5P1122 with a prior history of AGCT that was referred to our center at 29 weeks because of a symptomatic abdominal mass, compatible with a possible recurrence of AGCT. At 36 + 3 weeks, she underwent a cesarean delivery for preterm labor and a total hysterectomy with a radical surgical staging. A healthy female infant was delivered. The patient received a platinum-based chemotherapy, with a 26-month follow-up negative for recurrence. Analyzing our case with the four identified by the literature review, three were recurrent and two were primary AGCT. Only one required surgery for AGCT at 15 weeks, while another underwent chemotherapy in pregnancy. In the other three cases, surgery for AGCT was done at the time of cesarean delivery. There were three cases of preterm delivery. All five pregnancies resulted in the birth of live babies with weight adequate for gestational age. In conclusion, AGCT diagnosed in pregnancy is rare, reported in only five cases. All gave birth to live babies in the third trimester, and maternal outcome at up to 18 months showed no recurrence.

Highlights

Granulosa cell tumors account for 5–8% of all ovarian tumors [1]
We describe a new case of recurrent Adult granulosa cell tumor (AGCT) in pregnancy
As AGCT is often initially managed with unilateral oophorectomy in women of reproductive age, pregnancy in women with this history is possible

Summary

Introduction

Granulosa cell tumors account for 5–8% of all ovarian tumors [1]. They are classified according to histological and clinical presentation in two different types: Adult type and Juvenile type. The most common is the Adult type, which accounts for 95 % of all granulosa cell tumors, and it is usually diagnosed in the peri- and post-menopausal period. Amenorrhea, and endometrial hyperplasia are common symptoms of Adult granulosa cell tumor (AGCT) [1]. The Juvenile type instead accounts for 5% of all granulosa cell tumors and is diagnosed in the first two decades of life. Granulosa cell tumors can present during pregnancy, this happens infrequently, in only 10%

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